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Many people in the United States suffer from migraines. We don’t need to tell you about the inconvenience of these debilitating symptoms that can impact all facets of your lifestyle. Veterans suffering from migraines struggle with persistent pain, nausea, sensitivity to light, and even full-body fatigue. If you believe your migraines are a result of your service, you have options for compensation through the Department of Veterans Affairs (VA). Our VA disability lawyers are here to help.
To determine whether or not your condition is disabling, the VA often makes use of something called a Compensation and Pension (C&P) exam. While the C&P exam is intended to be an objective tool for measuring the severity of a condition, it often falls short when evaluating migraines. Veterans frequently report that their exam didn’t capture the true extent of their symptoms, and many receive a lower rating than expected as a result. Our attorneys can help you understand how to maximize your claim despite a disappointing C&P exam result.
Understanding the Role of the C&P Exam
The C&P exam is a routine part of the VA disability evaluation process. Once a veteran files a claim, the VA often schedules an exam with a medical professional, either employed or contracted by the VA, to assess the nature and severity of the claimed condition. For migraines, this exam typically involves a short interview with a clinician who reviews your medical history and asks about symptoms.
In theory, the exam is meant to give the VA a consistent framework for rating disabilities. In practice, however, the process can be rushed, impersonal, and disconnected from the reality of chronic migraines. Unlike conditions that can be seen on an X-ray or lab test, migraines are largely subjective. Their impact depends heavily on self-reported symptoms. This includes things like how often they occur, how long they last, and how severely they interfere with work or daily life.
The Problem with One-Time Snapshots
One of the major limitations of the C&P exam is that it offers only a snapshot of a chronic condition. Migraines, by their very nature, are episodic. You might not have one during the exam or even in the days leading up to one, but that doesn’t mean they aren’t frequent or debilitating.
Veterans often feel pressured to downplay symptoms in clinical settings. Some try to put on a brave face, others are asked vague or confusing questions, and many feel rushed or misunderstood. A ten-minute conversation in a bright medical office doesn’t accurately reflect what it’s like to spend several days a month in bed with a pounding headache, vomiting, and light sensitivity.
As a result, many C&P exam reports fail to capture:
- The actual number of migraine attacks per month
- Whether those attacks are prostrating, meaning they force the veteran to stop all activity
- The length of each episode
- The economic impact, such as missed work or reduced income
- The need for quiet and calm environments to manage symptoms
After decades of experience, our team knows that these missing facts contribute directly to a lower VA rating than our veterans deserve.
How Migraine Ratings Are Calculated—and Why Exams Matter
Migraines are evaluated using the VA Schedule for Rating Disabilities, which rates each condition as a percentage. While many disabilities are rated between 0% and 100%, migraines come with only four possible ratings: 0%, 10%, 30%, and 50%. The rating depends not on a clinical test but on the frequency, severity, and impact of attacks. The highest rating, 50%, is reserved for migraines that are very frequent, and that leave you unable to do anything more than lie down.
Because the rating criteria are somewhat vague, much of the decision hinges on how the examiner fills out the DBQ and the Disability Benefits Questionnaire, if they check a box indicating “less frequent attacks” or fail to document how migraines interfere with employment, your migraine VA rating may not reflect the true nature of your condition.
Common C&P Exam Shortcomings in Migraine Claims
There are a few factors that can lead to a C&P exam missing an existing migraine diagnosis. Some of the examples include the following:
Vague or Incomplete Notes
Many examiners use general language like “veteran reports headaches” or “symptoms are manageable with medication.” This kind of vague documentation fails to describe the intensity, frequency, and real-world impact of your migraines. These notes are more common among veterans who downplay their symptoms or attempt to put on a brave face.
Misunderstanding of “Prostrating”
Some medical professionals misunderstand what “prostrating” means in the context of a VA claim. They may assume it means the veteran needs to be unconscious or hospitalized. In reality, a prostrating migraine is one that forces you to lie down and stop all activity for an extended period.
Overreliance on Medication
Examiners may assume that if you’re on medication, your condition is well-controlled. But many veterans continue to have severe symptoms even with treatment. Medications often reduce migraines, and they can come with side effects like drowsiness or cognitive fog, but never fully eliminate them.
Lack of Functional Assessment
A key part of any disability claim is how the condition affects your ability to work or manage daily tasks. Unfortunately, many C&P reports omit any meaningful discussion of how migraines impact your employment, productivity, or quality of life.
Steps You Can Take to Strengthen Your Claim
While you can’t always control how a C&P exam unfolds, there are ways to ensure your experience is better reflected in the VA’s decision.
Track Your Migraines in a Log
Maintain a detailed headache diary that includes the date, duration, symptoms, and functional impact of each migraine. Note whether the episode forced you to lie down, miss work, or isolate in a dark room. Bring this log to the exam and submit it with your claim.
Write a Personal Statement
In addition to the log, consider writing a personal statement explaining how migraines have changed your life. Include specific examples—missed family events, difficulty working, or the emotional toll of constant unpredictability.
Submit Lay Evidence
Statements from spouses, friends, or coworkers can provide valuable insight into how migraines affect your daily function. These “buddy letters” are especially helpful if you don’t have extensive medical records.
Prepare for the C&P Exam
Before the exam, review your symptom history and migraine log. Go in with a clear understanding of what you want to convey. If you’re feeling nervous or unsure, practice describing your experience aloud beforehand. Be honest, specific, and avoid minimizing your pain.
Request a Copy of the Exam
After your exam, request a copy of the examiner’s notes and the completed DBQ. If there are errors, missing details, or statements that misrepresent your condition, you can respond by submitting a written rebuttal or supplemental evidence.
Appealing an Underrated Migraine Claim
If you receive a rating that doesn’t reflect the severity of your migraines, don’t give up. You have several appeal options under the VA’s modernized appeals system:
- Higher-Level Review: A senior reviewer reexamines your file without new evidence.
- Supplemental Claim: Submit new and relevant evidence to support your case—such as a corrected DBQ or updated migraine log.
- Board Appeal: You can appeal directly to the Board of Veterans’ Appeals with or without a hearing.
In each of these paths, providing strong evidence and a clear narrative can make a substantial difference.
How the VA Defines Economic Inadaptability
A critical—but often misunderstood—component of the highest migraine rating (50%) is the concept of “severe economic inadaptability.” This phrase refers to a veteran’s reduced ability to maintain substantially gainful employment due to the severity and frequency of their migraines. It does not mean a veteran must be completely unemployable. Instead, it considers the cumulative effects of the condition, like frequent absences or the need for accommodations.
C&P examiners often overlook or minimize this aspect unless the veteran directly connects their migraines to disruptions in employment. That’s why it’s essential to document missed workdays, disciplinary actions, or performance reviews that reflect the impact of migraines. Veterans who are self-employed can demonstrate economic inadaptability through tax records, missed client deadlines, or statements describing lost contracts due to recurring health issues.
If migraines make it difficult to stay employed, you have our sympathy first and foremost. Note that not being able to keep full-time work may not be enough to meet the threshold for this requirement. This concept is important in determining a fair migraine VA rating and should be addressed directly in both medical and lay evidence.
Don’t Let One Exam Define Your Disability
The VA system is complex, and unfortunately, the C&P exam process often fails to capture the true extent of chronic migraine conditions. But that doesn’t mean you’re out of options. If your claim was denied due to the exam results, the team at Gang & Associates is here to help. Contact us to learn how we can assist you with your appeal.